Adapter assembly with gimbal for interconnecting electromechanical surgical devices and surgical loading units, and surgical systems thereof

ABSTRACT

The present disclosure relates to adapter assemblies for use with and to electrically and mechanically interconnect electromechanical surgical devices and surgical loading units, and to surgical systems including hand held electromechanical surgical devices and adapter assemblies for connecting surgical loading units to the hand held electromechanical surgical devices.

CROSS REFERENCE TO RELATED APPLICATIONS

The present application claims priority to U.S. patent application Ser.No. 14/257,063, filed Apr. 21, 2014, the entire contents of which areincorporated by reference herein.

TECHNICAL FIELD

The present disclosure relates to adapter assemblies for use in surgicalsystems. More specifically, the present disclosure relates to adapterassemblies for use with and to electrically and mechanicallyinterconnect electromechanical surgical devices and surgical loadingunits, and to surgical systems including hand held electromechanicalsurgical devices and adapter assemblies for connecting surgical loadingunits to the hand held electromechanical surgical devices.

BACKGROUND

A number of surgical device manufacturers have developed product lineswith proprietary powered drive systems for operating and/or manipulatingthe surgical device. In many instances the surgical devices include apowered handle assembly, which is reusable, and a disposable endeffector or the like that is selectively connected to the powered handleassembly prior to use and then disconnected from the end effectorfollowing use in order to be disposed of or in some instances sterilizedfor re-use.

Many of the existing end effectors for use with many of the existingpowered surgical devices and/or handle assemblies are driven by a linearforce. For examples, end effectors for performing endo-gastrointestinalanastomosis procedures, end-to-end anastomosis procedures and transverseanastomosis procedures, each typically require a linear driving force inorder to be operated. As such, these end effectors are not compatiblewith surgical devices and/or handle assemblies that use a rotary motionto deliver power or the like.

In order to make the linear driven end effectors compatible with poweredsurgical devices and/or handle assemblies that use a rotary motion todeliver power, adapters and/or adapter assemblies are used to interfacebetween and interconnect the linear driven end effectors with thepowered rotary driven surgical devices and/or handle assemblies. Many ofthese adapter and/or adapter assemblies are complex devices includingmany parts and requiring extensive labor to assemble. Accordingly, aneed exists to develop adapters and/or adapter assemblies thatincorporate fewer parts, are less labor intensive to assemble, and areultimately more economical to manufacture.

SUMMARY

The present disclosure relates to adapter assemblies for use with and toelectrically and mechanically interconnect electromechanical surgicaldevices and surgical loading units, and to surgical systems includinghand held electromechanical surgical devices and adapter assemblies forconnecting surgical loading units to the hand held electromechanicalsurgical devices.

According to an aspect of the present disclosure, an adapter assemblyfor selectively interconnecting a surgical loading unit that isconfigured to perform a function and a surgical device that isconfigured to actuate the surgical loading unit, the surgical loadingunit including an axially translatable drive member, and the surgicaldevice including a plurality of rotatable drive shafts, is provided.

The adapter assembly includes a housing configured and adapted forconnection with the surgical device and to be in operative communicationwith each rotatable drive shaft of the plurality of rotatable driveshafts of the surgical device. An outer tube has a proximal endsupported by the housing and a distal end configured and adapted forconnection with the surgical loading unit. The distal end of the outertube is in operative communication with the axially translatable drivemember of the surgical loading unit. The outer tube defines alongitudinal axis. The outer tube can include a distal housing assemblyconfigured and adapted to engage a proximal end of the surgical loadingunit.

An articulation assembly includes a gimbal supported in the outer tubeand a plurality of threaded sleeves supported in the housing. Theplurality of threaded sleeves is coupled to the gimbal by at least onecable. In embodiments, the plurality of threaded sleeves is supported onat least one threaded screw. Rotation of at least one of the pluralityof rotatable drive shafts of the surgical device translates at least twoof the plurality of threaded sleeves to omni-directionally articulatethe gimbal relative to the longitudinal axis of the outer tube with theat least one cable. Articulation of the gimbal articulates the surgicalloading unit about the distal end of the outer tube. The gimbal caninclude a distal flange configured and adapted to engage the distalhousing assembly to enable the surgical loading unit to articulate inresponse to movement of the gimbal. In embodiments, the gimbal definesat least one slot in an outer surface thereof. The at least one cable issecured within the at least one slot.

The adapter assembly includes a firing shaft having a proximal endconfigured and adapted to couple to at least one of the plurality ofrotatable drive shafts of the surgical device and a distal endconfigured and adapted to couple to the axially translatable drivemember of the surgical loading unit to enable firing of the surgicalloading unit.

In embodiments, the firing shaft is configured and adapted to transmit arotational force through the gimbal to effectuate axially translation ofthe axially translatable drive member and fire the surgical loadingunit. In some embodiments, the firing shaft includes a proximal firingshaft and a distal firing shaft. The proximal and distal firing shaftscan be coupled together within the gimbal such that the distal firingshaft is movable relative to the proximal firing shaft. The proximalfiring shaft can include a ball member on a distal end thereof and thedistal firing shaft can include a socket on a proximal end thereof. Thesocket defines a socket bore and the ball member of the proximal firingshaft can be mounted within the socket bore.

In some embodiments, the gimbal defines a gimbal bore therethroughconfigured and adapted to receive the distal firing shaft such that thegimbal and the distal firing shaft are movable about an outer surface ofthe ball member.

In embodiments, the at least one threaded screw includes a first set ofthreads and a second set of threads. The first and second set of threadscan be threaded in opposite directions. A first one of the plurality ofthreaded sleeves can be threadably engaged with the first set of threadsand a second one of the plurality of threaded sleeves can be threadablyengaged with the second set of threads. Rotation of the at least onethreaded screw in a first rotational direction can approximate the firstone and the second one of the plurality of threaded sleeves. Rotation ofthe at least one threaded screw in a second rotational direction canseparate the first one and the second one of the plurality of threadedsleeves.

In embodiments, a firing trigger is secured to the adapter assembly. Thefiring trigger can be secured to the housing.

According to another aspect of the present disclosure, anelectromechanical surgical system is provided. The electromechanicalsurgical system includes a surgical loading unit including at least oneaxially translatable drive member and a handle-held electromechanicalsurgical device. The handle-held electromechanical surgical deviceincludes a housing and at least one rotatable drive shaft supported inthe housing.

An adapter assembly is selectively connectable between the housing ofthe surgical device and the surgical loading unit. The adapter assemblyincludes an articulation assembly and a firing shaft.

The articulation assembly includes a gimbal and a plurality of threadedsleeves. The plurality of threaded sleeves is coupled to the gimbal byat least one cable. The plurality of threaded sleeves is movable toarticulate the gimbal with the at least one cable. Articulation of thegimbal articulates the surgical loading unit.

The firing shaft is connectable between the at least one rotatable driveshaft of the surgical device and the at least one axially translatabledrive member. The firing shaft is movable with the gimbal toomni-directionally articulate the surgical loading unit and rotatable totranslate the at least one axially translatable drive member through thesurgical loading unit.

According to another aspect of the present disclosure, a method ofarticulating a surgical loading unit operatively coupled to a surgicaldevice by an adapter is provided. The method includes rotating at leastone rotatable drive shaft of the surgical device to rotate at least onethreaded screw supported within the adapter and axially translate aplurality of threaded sleeves along the at least one threaded screw,translating a plurality of cables secured between the plurality ofthreaded sleeves and a gimbal, and articulating the gimbal with theplurality of cables to articulate the surgical loading unit relative toadapter. The method can involve rotating a firing shaft to fire thesurgical loading unit.

Further details and aspects of exemplary embodiments of the presentdisclosure are described in more detail below with reference to theappended figures.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate embodiments of the disclosureand, together with a general description of the disclosure given above,and the detailed description of the embodiment(s) given below, serve toexplain the principles of the disclosure, wherein:

FIG. 1A is a perspective view of an electromechanical surgical system inaccordance with the principles of the present disclosure;

FIG. 1B is an enlarged, perspective view of the indicated area of detailshown in FIG. 1A;

FIG. 2 is an enlarged, perspective view of an adapter assembly of theelectromechanical surgical system of FIG. 1A;

FIG. 3 is an enlarged, perspective view of a distal portion of theadapter assembly of FIG. 2;

FIG. 4 is a bottom, cross-sectional view the adapter assembly of FIG. 2,as taken along line 4-4 of FIG. 2, illustrating an articulation assemblythereof in a first condition;

FIG. 5 is a side, perspective view, with parts separated, of a proximalportion of the adapter assembly of FIG. 2;

FIG. 6 is front, perspective view of the proximal portion of the adapterassembly of FIG. 2, as taken along line 6-6 of FIG. 4;

FIG. 7 is an enlarged, side perspective view of a portion of thearticulation assembly and a portion of a firing assembly, with thearticulation assembly shown in the first condition;

FIG. 8 is an enlarged, bottom perspective view of a section of theportion of the articulation assembly shown in FIG. 7;

FIG. 9 is an enlarged, cross-sectional, bottom view of the indicatedarea of detail shown in FIG. 4, with the articulation assembly beingshown in a second condition;

FIG. 10 is an enlarged, perspective view, with parts separated, of thedistal portion of the adapter assembly shown in FIG. 3;

FIG. 11 is an enlarged, perspective view of a gimbal of the articulationassembly;

FIG. 12 is an enlarged, side, perspective view of the distal portion ofthe adapter assembly shown in FIG. 3, with portions thereof removed forclarity, the distal portion of the adapter assembly being shown in annon-articulated condition;

FIG. 13 is an enlarged, front, perspective view of a distal portion ofthe articulation assembly;

FIG. 14 is a side, cross-sectional view of the adapter assembly of FIG.2, as taken along line 14-14 of FIG. 2;

FIG. 15 is an enlarged, side, cross-sectional view of the indicated areaof detail shown in FIG. 14;

FIG. 16 is an enlarged, bottom, cross-sectional view of the indicatedarea of detail shown in FIG. 4;

FIG. 17 is an enlarged, perspective view, with parts separated, of asurgical loading unit of the electromechanical surgical system of FIG.1A;

FIGS. 18A and 18B are progressive, side, perspective views illustratinga proximal portion of a surgical loading unit of the electromechanicalsurgical system of FIG. 1A being secured to the distal portion of theadapter assembly shown in FIG. 3;

FIG. 19 is an enlarged, front, perspective view of the distal endportion of the adapter assembly of FIG. 3, the distal end portion of theadapter assembly being shown in an articulated condition;

FIG. 20 is an enlarged, rear, perspective view of the distal end portionof the adapter assembly of FIG. 3 with portions thereof removed forclarity, the distal end portion of the adapter assembly being shown inthe articulated condition;

FIG. 21 is an enlarged, front, perspective view of a portion of theelectromechanical surgical system of FIG. 1A, the surgical loading unitthereof being shown in the articulated condition;

FIG. 22 is a side, perspective view, with parts separated, of a proximalportion of another embodiment adapter assembly in accordance with thepresent disclosure; and

FIG. 23 is a side, cross-sectional view of the proximal portion of theadapter assembly of FIG. 22.

DETAILED DESCRIPTION

Electromechanical surgical systems of the present disclosure includesurgical devices in the form of powered hand held electromechanicalinstruments configured for selective attachment to a plurality ofdifferent end effectors that are each configured for actuation andmanipulation by the powered hand held electromechanical surgicalinstrument. In particular, the presently described electromechanicalsurgical systems include adapter assemblies that interconnect thepowered hand held electromechanical surgical instruments to theplurality of different end effectors. Each adapter assembly includes anarticulation assembly that is operatively coupled to a powered hand heldelectromechanical surgical instrument for effectuating actuation and/ormanipulation thereof. The articulation assembly includes one or morecables that interconnect a gimbal and two or more threaded sleeves. Thegimbal couples to one of the plurality of end effectors such that axialmovement of the threaded sleeves moves the one or more cables to rotatethe gimbal and effectuate articulation of the end effector about adistal end of the adapter assembly.

Embodiments of the presently disclosed electromechanical surgicalsystems, surgical devices/handle assemblies, adapter assemblies, and/orloading units are described in detail with reference to the drawings, inwhich like reference numerals designate identical or correspondingelements in each of the several views. As used herein the term “distal”refers to that portion of the system, assembly, device, and/or componentthereof, farther from the user, while the term “proximal” refers to thatportion of the system, assembly, device, and/or component thereof,closer to the user.

Turning now to FIGS. 1A and 1B, an electromechanical surgical system, inaccordance with the present disclosure, generally referred to as 10,includes a surgical device 100 in the form of a powered hand heldelectromechanical instrument, an adapter assembly 200, and a loadingunit 300 (e.g., an end effector, multiple- or single-use loading unit).Surgical device 100 is configured for selective connection with adapterassembly 200, and, in turn, adapter assembly 200 is configured forselective connection with loading unit 300. Together, surgical device100 and adapter assembly 200 may cooperate to actuate loading unit 300.

Surgical device 100 includes a handle housing 102 including a circuitboard (not shown) and a drive mechanism (not shown) situated therein.The circuit board is configured to control the various operations ofsurgical device 100. Handle housing 102 defines a cavity therein (notshown) for selective removable receipt of a rechargeable battery (notshown) therein. The battery is configured to supply power to any of theelectrical components of surgical device 100.

Handle housing 102 includes an upper housing portion 102 a which housesvarious components of surgical device 100, and a lower hand grip portion102 b extending from upper housing portion 102 a. Lower hand gripportion 102 b may be disposed distally of a proximal-most end of upperhousing portion 102 a. The location of lower housing portion 102 brelative to upper housing portion 102 a is selected to balance a weightof a surgical device 100 that is connected to or supporting adapterassembly 200 and/or loading unit 300.

Handle housing 102 provides a housing in which the drive mechanism issituated. The drive mechanism is configured to drive shafts and/or gearcomponents in order to perform the various operations of surgical device100. In particular, the drive mechanism is configured to drive shaftsand/or gear components in order to selectively articulate loading unit300 about a longitudinal axis “X” and relative to a distal end ofadapter assembly 200, to selectively rotate loading unit 300 aboutlongitudinal axis “X” and relative to handle housing 102, to selectivelymove/approximate/separate an anvil assembly 310 and a cartridge assembly320 of loading unit 300 relative to one another, and/or to fire astapling and cutting cartridge within cartridge assembly 320 of loadingunit 300.

Handle housing 102 defines a connection portion 104 configured to accepta proximal end of adapter assembly 200. Connection portion 104 houses atrigger contact surface 105 in electrical communication with the circuitboard and a plurality of rotatable drive shafts or connectors 106. Eachrotatable drive shaft of the plurality of rotatable drive shafts can beindependently, and/or dependently, actuatable and rotatable by the drivemechanism (not shown) housed within housing handle 102. In embodiments,the plurality of rotatable drive shafts 106 includes rotatable driveshafts, 106 a, 106 b, 106 c, 106 d, and 106 e arranged in a common planeor line with one another. As can be appreciated, the plurality ofrotatable drive shafts can be arranged in any suitable configuration.The drive mechanism may be configured to selectively drive one of therotatable drive shafts 106 of surgical instrument 100, at a given time.

Handle housing 102 supports a plurality of finger-actuated controlbuttons, rocker devices and the like for activating various functions ofsurgical device 100. For example, handle housing 102 supports aplurality of actuators including, for example, an articulating pad suchas articulating pad 108, to effectuate articulation of end effector 300as will be described in greater detail below. Articulating pad 108 isconfigured to contact a plurality of sensors 108 a that cooperate witharticulating pad 108 to enable omni-directional articulation of loadingunit 300 relative to adapter assembly 200. In embodiments, one or moreof the plurality of sensors 108 a correspond to different yaw and/orpitch angles, relative to longitudinal axis “X,” to which loading unit300 can be moved, upon activation of one or more of the plurality ofsensors 108 a in response to depression of different portions ofarticulating pad 108. Handle housing 102 can support actuators 107 a,107 b, which as will be described in great detail below, can be disposedin electrical communication with rotatable drive shafts 106 d, 106 e foractuation thereof to enable adjustment of one or more of the componentsof adapter assembly 200. Any of the presently described actuators canhave any suitable configuration (e.g., button, knob, toggle, slide etc.)

Reference may be made to International Application No.PCT/US2008/077249, filed Sep. 22, 2008 (Inter. Pub. No. WO 2009/039506),and U.S. Patent Application Publication No. 2011/0121049, filed on Nov.20, 2009, the entire contents of each of which being incorporated hereinby reference, for a detailed description of various internal componentsof and operation of exemplary electromechanical surgical systems, thecomponents of which are combinable and/or interchangeable with one ormore components of electromechanical surgical systems 10 describedherein.

With reference to FIGS. 2 and 3, adapter assembly 200 includes a housing202 at a proximal end portion thereof and an outer tube 204 that extendsdistally from housing 202 to a distal end portion 2040 thereof.

Turning now to FIGS. 4-9, housing 202 of adapter assembly 200 includes aproximal housing 202 a and a distal housing 202 b that support a firingtrigger 205. Firing trigger 205 includes a trigger contact surface 205 aand is slidably disposed in proximal housing 202 a. Proximal housing 202a includes a housing body 206 defining a central slot 206 a therethroughand having a distal lip 206 b extending radially outwardly therefrom.Housing body 206 supports a mounting assembly 210 thereon and includesan elongate tongue 208 extending distally therefrom that defines anelongate channel 208 a that slidably receives firing trigger 205.

Mounting assembly 210 is supported on housing body 206 and includes ashaft 212 that extends outwardly from housing body 206, a spring 214that is supported about an outer surface of shaft 212, and a mountingbutton 216 that engages spring 214 and shaft 212. Spring 214 contacts abottom surface of mounting button 216 to bias mounting button 216upwardly to an extended position spaced from housing body 206. Spring214 is sufficiently compressible to enable mounting button 216 to bedepressed downwardly from the extended position to a compressedposition. In the compressed position, mounting button 216 is disposed inclose approximation with housing body 206 and offset from the extendedposition. Mounting button 216 includes sloped engagement features 216 athat are configured to contact connection portion 104 a (FIG. 1A) ofhandle housing 102 while mounting button 216 is in the extended positionto facilitate securement of housing 202 to connection portion 104 ofhandle housing 102.

As seen in FIGS. 4 and 5, distal housing 206 b includes a firsthalf-section 218 a and a second half-section 218 b. First half-section218 a includes a plurality of pins 220 extending therefrom and secondhalf-section 218 b defines a plurality of bores 222 adapted to receivethe plurality of pins 220 of first half-section 218 a to mate the firstand second half-sections 218 a, 218 b together. Each of first and secondhalf-sections 218 a, 218 b defines an internal lip receiving annularrecess 224 adapted to receive a portion of distal lip 206 b of proximalhousing 202 a to facilitate securement of proximal and distal housings202 a, 202 b. Each of first and second half-sections 218 a, 218 bdefines an articulation-assembly-receiving recess 226 that is incommunication with an outer-tube-receiving channel 228. Eachouter-tube-receiving channel 228 is defined through a distal end of oneof first and second half-sections 218 a, 218 b.

An articulation assembly 230 is supported within housing 202 and outertube 204. Articulation assembly 230 includes a pair of sleeve assemblies240 a, 240 b at a proximal end thereof and a gimbal 250 at a distal endthereof. The pair of sleeve assemblies 240 a, 240 b and gimbal 250 isconnected by a plurality of cables 260. As depicted in FIG. 6, anddescribed in greater detail below, the plurality of cables 260 includesa first cable 260 a, a second cable 260 b, a third cable 260 c, and afourth cable 260 d.

With reference to FIGS. 6-8, each of the pair of sleeve assemblies 240a, 240 b includes a support shaft 242, a threaded screw assembly 244, abearing block 245, and a pair of threaded sleeves 246, 248.

As seen in FIG. 4, support shaft 242 includes a proximal portion 242 areceived in central slot 206 a (see FIG. 5) of proximal housing 202 a.Proximal portion 242 a defines a threaded bore 242 b therein. Eachthreaded bore 242 b receives therein a screw 243 that is advancedthrough a screw passage 203 defined in proximal housing 202 a tofacilitate securement of articulation assembly 230 to proximal housing202 a. Support shaft 242 further includes a distal portion 242 c thatextends distally from proximal portion 242 a.

With reference to FIG. 5, each screw 243 can function as a cabletensioner to adjust overall slack in one or more of the plurality ofcables 260 as depicted by axial lines of translation “A1” and “A2” ofthe pair of sleeve assemblies 240 a, 240 b and by rotational arrows “B1”and “B2” of screws 243. For example, with reference again to FIG. 4, thepair of sleeve assemblies 240 a, 240 b are disposed in offsetlongitudinal relationship with respect to each other (e.g., comparerelative longitudinal relationship between bearing blocks 245 and/ordistal ends of threaded screw assemblies 244) to depict differences inslack adjustment in each sleeve assembly 240 a, 240 b. In embodiments,slack adjustments of one of the pair of sleeve assemblies 240 a, 240 bcan be different and/or the same as the other of the pair of sleeveassemblies 240 a, 240 b, and likewise can be further adjusted asnecessary to achieve a desired cable slack in one or more of theplurality of cables 260. In particular, tightening and/or looseningrotation of screw 243 relative to one of threaded bores 242 bapproximates and/or separates screw 243 relative to support shaft 242 toaxially move one or both of the pair of sleeve assemblies 240 a, 240 b(proximally and/or distally) to adjust tension in one or more of theplurality of cables 260. In embodiments, tightening of one or bothscrews 243 draws one or both of the pair of sleeve assemblies 240 a, 240b proximally, and loosening of one or both screws distally advances oneor both of the pair of sleeve assemblies 240 a, 240 b. In someembodiments, loosening of one or both screws 243 draws one or both ofthe pair of sleeve assemblies 240 a, 240 b proximally, and tightening ofone or both screws distally advances one or both of the pair of sleeveassemblies 240 a, 240 b. As can be appreciated, each screw 243 can beindependently and/or dependently rotatable (e.g., tightening rotation,loosening rotation, clockwise rotation, and/or counterclockwiserotation) with respect to the other screw 243.

Threaded screw assembly 244 includes a threaded screw 244 a extendingdistally from an input socket 244 b with a distal end of input socket244 b being mechanically coupled to a proximal end of threaded screw 244a. Each input socket 244 b is configured to engage one of the pluralityof rotatable drive shafts 106 of handle housing 102. For example, inputsocket 244 b of sleeve assembly 240 b can be mechanically coupled torotatable drive shaft 106 a and input socket 244 b of sleeve assembly240 a can be mechanically coupled to rotatable drive shaft 106 c.

Threaded screw 244 a includes a first thread 244 c and a second thread244 d that are threaded in opposite directions. For example, firstthread 244 c can be a left-hand thread and second thread 244 d can be aright-hand thread, and vice versa. In embodiments, first and secondthreads 244 c, 244 d have the same thread pitch. Threaded screw 244 acan include a third thread 244 e. Third thread 244 e can be either rightor left handed and can have the same and/or different pitch as the firstand/or second threads 244 c, 244 d. As can be appreciated, any of first,second, or third threads 244 c, 244 d, 244 e can have any suitableshape, dimension, and/or configuration. With reference to FIG. 4,threaded screw 244 includes a retaining member 244 f extending from anouter surface thereof. Retaining member 244 f can have a plurality ofopposed sections. In some embodiments, retaining member 244 f is anannular lip.

As seen in FIG. 8, bearing block 245 is mounted on proximal end portionof support shaft 242 and on threaded screw assembly 244. Bearing block245 includes distal plate 245 a and a proximal plate 245 b that aresecured together by a pair of fasteners 245 c, 245 d. With referencealso to FIG. 4, distal and proximal plates 245 a, 245 b define first andsecond channels 245 e, 245 f therethrough. First channel 245 e receivesa proximal portion of threaded screw 244 and encloses retaining member244 f and a thrust bearing 247. Second channel 245 f receives supportshaft 242, which can be fixedly secured therein to facilitate axialadvancement of one of the pair of sleeve assemblies 240 a, 240 b uponrotation of screws 243 as described above. As can be appreciated,bearing block 245 of sleeve assembly 240 a is a mirror image of bearingblock 245 of sleeve assembly 240 b.

Referring to FIGS. 7 and 8, each of the pair of threaded sleeves 246,248 has an L-shaped profile. As illustrated in FIG. 9, threaded sleeve246 defines first and second bores 246 a, 246 b therethrough with firstbore 246 a being threaded and second bore 246 b being smooth. Similarly,threaded sleeve 248 defines first and second bores 248 a, 248 btherethrough with first bore 248 a being threaded and second bore 248 bbeing smooth. Each of the pair of sleeve assemblies 240 a, 240 b isarranged so that threaded bores 246 a, 248 a receive threaded screw 244a such that first thread 244 c threadably engages threaded bore 246 aand such that second thread 244 d threadably engages threaded bore 248a. Each of the pair of sleeve assemblies 240 a, 240 b is also arrangedso that smooth bores 246 b, 248 b of threaded sleeves 246, 248 receivedistal portion 242 c of support shaft 242 such that threaded sleeves246, 248 move axially along distal portion 242 c of support shaft 242.In embodiments, threaded sleeve 246 of sleeve assembly 240 a can bedisposed in mirrored relation with threaded sleeve 246 of sleeveassembly 240 b. As seen in FIG. 8, each of the pair of threaded sleeves246, 248 define shaft-receiving channels 246 c, 248 c andcable-receiving channels 246 d, 248 d in side surfaces thereof. Each ofthe pair of threaded sleeves 246, 248 is coupled to one of the pluralityof cables 260 by a cable ferrule 262 connected to a proximal end of eachof the plurality of cables 260. Cable-receiving channels 246 d, 248 dreceive cable ferrule 262 of one of the plurality of cables 260 thereinto secure one of the plurality of cables 260 to each of the pair ofthreaded sleeves 246, 248.

With reference to FIGS. 10-13, each of the plurality of cables 260extends distally to a retaining ball 262 (see FIG. 13) to secure thedistal end of the first, second, third, and fourth cables 260 a-260 d togimbal 250. Each opposite pair of the plurality of cables 260 can havetwo cables that are secured to gimbal 250 at locations 180 degrees apart(e.g., first and fourth cables 260 a, 260 d or second and third cables260 b, 260 c).

As seen in FIG. 6, each opposite pair of the plurality of cables 260 hasproximal ends that connect to the pair of threaded sleeves 246, 248 onthe same threaded screw 244. Thus, the proximal end of the first andfourth cables 260 a, 260 d connect to one threaded screw 244, and theproximal end of the second and third cables 260 b, 260 c connect to theother threaded screw 244. It is contemplated that one or more of theplurality of cables can criss-cross within outer tube 204.

Referring again to FIGS. 10-13, gimbal 250 has a proximal portion 250 awith a generally rounded shape and a distal portion 250 b extending fromproximal portion 250 a. Proximal portion 250 a defines a plurality ofball-retaining slots 252 (e.g., four) in a distal outer surface thereofso that each ball-retaining slot of the plurality of ball-retainingslots 252 is dimensioned to receive one of retaining balls 262 of theplurality of cables 260 to secure each of the plurality of cables 260 togimbal 250.

Proximal portion 250 a of gimbal 250 includes a plurality of spacedapart wings 254 that extend from an outer surface thereof. Each wing ofthe plurality of spaced-apart wings 254 includes a top surface 254 a andside surfaces 254 b. Side surfaces 254 b of adjacent wings of theplurality of spaced-apart wings 254 define a plurality of slots 256about the outer surface of proximal portion 250 a. The plurality ofslots 256, which are configured to receive the plurality of cables 260,are in communication with the plurality of ball-retaining slots 252 andextend proximally therefrom.

Distal portion 250 b of gimbal 250 includes a tubular shaft 251 havingan upwardly depending flange 253 extending from an outer surface oftubular shaft 251. Upwardly depending flange 253 defines a pair ofarcuate side channels 253 a, 253 b in side surfaces thereof. The pair ofarcuate side channels 253 a, 253 b form a pair of opposed teeth 253 c,253 d that extend from side surfaces of flange 253. Proximal and distalportions 250 a, 250 b of gimbal 250 define a gimbal bore 258 (see FIGS.11-12) that extends therethrough and includes first section 258 adefined by inner surfaces of distal portion 250 b and a second section258 b defined by inner surfaces of proximal portion 250 a.

Referring to FIG. 14, a firing assembly 270 is supported within housing202 and outer tube 204 of adapter assembly 200. Firing assembly 270includes an input socket 272 adapted to couple to rotatable drive shaft106 b of housing handle 102 (see FIG. 1A), a proximal firing shaft 274extending distally from input socket 272, a distal firing shaft 276extending distally from proximal firing shaft 274, and a pin 278 thatsecures proximal and distal firing shafts 274, 276 together withingimbal bore 258.

With continued reference to FIG. 14, a housing bearing member 280supports a proximal end of proximal firing shaft 274 within proximalhousing 202 a, and proximal and distal mounting members 282, 284 supporta distal end of proximal firing shaft 274 within outer tube 204. Housingbearing member 280 includes a thrust bearing 282 that receives proximalfiring shaft 274 therethrough to enable proximal firing shaft 274 torotate. Proximal mounting member 282 defines a central passage 282 atherethrough that receives the proximal firing shaft 274.

As seen in FIGS. 10, 15, and 16, distal mounting member 284 includes aproximal section 284 a and a distal section 284 b. Proximal section 284a defines a pair of screw openings 284 c therethrough with each of thepair of screw openings 284 c being disposed on opposed top and bottomsurfaces of proximal section 284 a. Similarly, distal section 284 b ofdistal mounting member 284 defines a pair of screw openings 284 dtherethrough with each of the pair of screw openings 284 d beingdisposed on opposed top and bottom surfaces of distal section 284 b.Distal section 284 b of distal mounting member 284 further includes aninner surface 284 e that defines a hemispherical opening 284 f thatreceives proximal portion 250 a of gimbal 250 to enable gimbal 250 toarticulate omni-directionally therein.

Referring again to FIG. 14, the proximal end of proximal firing shaft274 is received in a distal end of input socket 272, and the distal endof proximal firing shaft 274 includes a coupling member 274 a. As seenin FIG. 10, coupling member 274 a defines an elongate top slot 274 btherethrough and a side slot 274 c therethrough that is disposedtransverse to top slot 274 b. Elongate top slot 274 b receives pin 278and side slot 274 c receives a pin coupling 290 defining a pin bore 292therein that receives pin 278.

With continued reference to FIGS. 10 and 14-16, distal firing shaft 276includes a proximal portion 276 a having a hemispherical shape, acentral shaft 276 b extending distally from a distal end of proximalportion 276 a, and a distal tip 276 c extending distally from a distalend of central shaft 276 b. Proximal portion 276 a of distal firingshaft 276 defines a pin channel 276 d that extends therethrough.Proximal portion 276 a of distal firing shaft 276 has an inner surfacethat defines a hemispherical opening 276 e adapted to receive couplingmember 274 a of proximal firing shaft 274. Central shaft 276 b defines aledge 276 f that is recessed from a top surface of central shaft 276 b.

As seen in FIGS. 3, 10, 15 and 16, distal end portion 2040 of outer tube204 includes a first segment 2042, a second segment 2044, a thirdsegment 2046, and a fourth segment 2048.

First segment 2042 of distal end portion 2040 of outer tube 204 definesa pair of screw openings 2042 a, 2042 b that correspond with the pair ofscrew openings 284 c of distal mounting member 284. The pair of screwopenings 2042 a, 2042 b of first segment 2042 and the pair of screwopenings 284 c of distal mounting member 284 receive a pair of screws204 a, 204 b to secure proximal section 284 a of distal mounting member284 within an opening 2042 c defined within a distal end of firstsegment 2042.

Second segment 2044 of distal end portion 2040 of outer tube 204includes a proximal section 2044 a, and a distal section 2044 b thatextends from proximal section 2044 a. Second segment 2044 defines acentral opening 2044 c that extends through proximal and distal sections2044 a, 2044 b. Proximal section 2044 a defines a pair of screw openings2044 d therethrough with each of the pair of screw openings 2044 d beingdisposed on opposed top and bottom surfaces of proximal section 2044 a.The pair of screw openings 2044 d of second segment 2044 correspondswith the pair of screw openings 284 d of distal mounting member 284 sothat a pair of screws 204 c, 204 d secures second segment 2044 overdistal section 284 b of distal mounting member 284. Distal section 2044b defines pin opening 2044 e. Pin opening 2044 e can be aligned with pinchannel 276 d of distal firing shaft 276 to enable pin 278 to beadvanced therethrough for securement within pin coupling 290.

Third segment 2046 of distal end portion 2040 of outer tube 204 has acylindrical body 2046 a that mounts over distal section 2044 b of secondsegment 2044 and covers pin opening 2044 e thereof. Third segment 2046includes a U-shaped shoe 2046 b that extends distally from a distalsurface of cylindrical body 2046 a. A central channel 2046 c is definedthrough U-shaped shoe 2046 b and cylindrical body 2046 a, and isconfigured to receive distal portion 250 b of gimbal 250.

Fourth segment 2048 of distal end portion 2040 of outer tube 204includes a pair of arms 2048 a, 2048 b that extends from fourth segment2048. The pair of arms 2048 a, 2048 b are disposed in spaced apart andmirrored relation to one another. A pair of screw openings 2048 c, 2048d is defined in fourth segment 2048 and are aligned with a pair of screwbores 2046 d, 2046 e defined within third segment 2046 so that a pair ofscrews 204 e, 204 f can be received by the pair of screw openings 2048c, 2048 d of the fourth segment 2048 and the pair of screw bores 2046 d,2046 e of the third segment 2046 to secure third and fourth segments2046, 2048 together. Fourth segment 2048 defines a plunger opening 2048e that receives a plunger assembly 2060 of distal end portion 2040 ofouter tube 204.

Plunger assembly 2060 includes a plunger 2060 a that is biased throughplunger opening 2048 e by a spring 2060 b (see FIG. 15). Plungerassembly 2060 and the pair of arms 2048 a, 2048 b cooperate tofacilitate securement of the proximal end of loading unit 300 to distalend portion 2040 as described in greater detail below (see FIGS. 18A and18B).

As illustrated in FIG. 10, a tongue 2048 f depends from fourth segment2048 and defines an opening 2048 f therethrough that receives distal tip276 c of distal firing shaft 276 therethrough. Tongue 2048 f supports agear 2050 between a proximal surface of tongue 2048 f and a distalsurface of U-shaped shoe 2046 b of third segment 2046 so that teeth 2050a extending from gear 2050 are positioned between mating surfaces 2048hof each of the pair of arms 2048 a, 2048 b of fourth segment 2048 ofdistal end portion 2040 of outer tube 204.

Inner surfaces of gear 2050 define a channel 2050 b therethrough. Innersurfaces of gear 2050 include a flat surface 2050 c (see FIG. 15) thatis supported on ledge 276 f of distal firing shaft 276.

Turning now to FIG. 17, loading unit 300 includes anvil 310 andcartridge assembly 320 that are pinned together by a pair of pins 315 a,315 b and movable between open and closed conditions. Anvil 310 andcartridge assembly 320 cooperate to apply a plurality of linear rows offasteners “F” (e.g., staples). In certain embodiments, the fasteners areof various sizes, and, in certain embodiments, the fasteners havevarious lengths or rows, e.g., about 30, 45 and 60 mm in length.

Cartridge assembly 320 includes a base 322 secured to a mounting portion324, a frame portion 326, and a cartridge portion 328 defining aplurality of fastener retaining slots 328 a and a knife slot 328 b in atissue engaging surface thereof. Mounting portion 324 has matingsurfaces 324 a, 324 b on a proximal end thereof and defines a receivingchannel 324 c therein that supports frame portion 326, cartridge portion328, and a fastener firing assembly 330 therein. Cartridge assembly 320supports a biasing member 340 that engages anvil 310.

Fastener firing assembly 330 includes an electrical contact member 332in electrical communication with circuit board of surgical device 100(FIG. 1A), a bearing member 334, a gear member 336 that engages gear2050 of distal end portion 2040 of outer tube 204, and a screw assembly338. Screw assembly 338 includes a lead screw 338 a, a drive beam 338 b,and an actuation sled 338 c that is engagable with a plurality of pushermembers 338 d.

Cartridge assembly 320 also supports a pair of plunger assemblies 350 a,350 b. Each of the pair of plunger assemblies 350 a, 350 b includes aspring 352, a plunger 354, and a pin 356 that secures each plungerassembly to mounting portion 324. Plunger assemblies 350 a, 350 bcooperate with the proximal end of cartridge portion 328 to facilitatesecurement of cartridge portion 328 within mounting portion 324.

In order to secure the proximal end of loading unit 300 to distal endportion 2040 of outer tube 204, the proximal end of loading unit 300 isaligned with distal end portion 2040 of outer tube 204 as seen in FIG.18A so that the proximal end of loading unit 300 can be snapped togetherwith distal end portion 2040 as seen in FIG. 18A. Referring also toFIGS. 10 and 17, mating surfaces 324 a, 324 b of loading unit 300 engagewith mating surfaces 2048h of fourth segment 2048 so that the teeth ofgear member 336 of loading unit 300 enmesh with the teeth of gear 2050.

In operation, depression of articulating pad 108 contacts one more ofthe plurality of sensors 108 a to electrically communicate with thecircuit board, activate one or both of rotatable drive shafts 106 a, 106c (due to an actuation of a motor (not shown) within handle housing102), and effectuate rotation of threaded screw assembly 244 of one orboth of the pair of sleeve assemblies 240 a, 240 b. In particular,rotation of each threaded screw assembly 244 is effectuated by virtue ofrotational engagement between input socket 244 b of one of the pair ofsleeve assemblies 240 a, 240 b and one of rotatable drive shafts 106 a,106 c. Rotation of threaded screw 244 a axially moves the pair ofthreaded sleeves 246, 248 along the respective support shaft between anapproximated condition (see FIG. 9) and a separated condition (see FIG.4), as illustrated by lines “C1,” “C2,” “C3,” and “C4” shown in FIG. 7.Relative axial movement of the pair of threaded sleeves 246, 248proximally draws/retracts/tightens one/a first cable of one of theopposite pairs of cables (e.g., first cable 260 a and fourth cable 260 dbeing a first opposite pair of cables, and second cable 260 b and thirdcable 260 c being a second opposite pair of cables) of the plurality ofcables 260 and distally lets out/extends/releases another/a second cableof one of the opposite pairs of cables to rotate/pivot/articulate gimbal250. As gimbal 250 rotates, distal portion 250 b of gimbal 250 engagescylindrical body 2046 a and/or U-shaped shoe 2046 b of third segment2046 to articulate distal end portion 2040 relative to outer tube 204about longitudinal axis “X.” Movement of distal end portion 2040articulates loading unit 300 relative to outer tube 204 aboutlongitudinal axis “X” in any direction (e.g., omni-directionally) asseen in FIGS. 19-21. More particularly, while longitudinally fixed tothe distal end of outer tube 204 (and first and second segments 2042,2044 of distal end portion 2040), loading unit 300 (and third and fourthsegments 2046, 2048 of distal end portion 2040) can be articulated inany direction relative to “X,” “Y,” and/or “Z” axes that extend from acentral point “P” defined in the distal end portion 2040 to positionloading unit 300 at any desired orientation.

Tension/slack in one or more of the plurality of cables 260 may need tobe adjusted, for example, before, during, and/or after one or more usesof system 10. To effectuate a tightening and/or loosening ofslack/tension, one or both actuators 107 a, 107 b (see FIG. 1A), can beactuated to impart rotational movement to one or both of rotatable drivemembers 106 d, 106 e. With rotatable drive members 106 d, 106 e inengagement with proximal ends of screws 243, rotation of rotatable drivemembers 106 d, 106 e causes one or both of screws 243 to rotate.Rotation of one or both screws 243 adjusts tension in one or more of theplurality of cables 260 by moving one or both of the plurality of thepair of sleeve assemblies 240 a, 240 b as described above.

To fire the plurality of fasteners “F,” firing trigger 205 of adapterassembly 200 is actuated so that trigger contact surface 205 a contactstrigger contact surface 105 of handle housing 102 to rotate rotatabledrive member 106 b (due to an activation of a motor (not shown) withinhandle housing 102). Rotation of rotatable drive member 106 b causesproximal firing shaft 274 to rotate with distal firing shaft 276 aboutlongitudinal axis “X” such that gear 2050 rotates gear 336 of loadingunit 300. Rotation of gear 336 rotates lead screw 338 a and enablesdrive beam 338 a to axially advance along lead screw 338 a and throughlongitudinal knife slot 328 b by virtue of the threaded engagementbetween lead screw 338 a and drive beam 338 a. Drive beam 338 a engagesanvil 310 to maintain anvil and cartridge assembly 310, 320 inapproximation. Distal advancement of drive beam 338 b advances actuationsled 338 c into engagement with the plurality of pusher members 328 andfires the plurality of fasteners “F” from the plurality of fastenerretention slots 328 a for forming against corresponding fastener formingpockets defined within anvil 310. Loading unit 300 can be reset andfastener cartridge 328 can be replaced so that loading unit 300 can thenbe re-fired as desired.

Turning now to FIG. 22, a proximal portion of another embodiment of anadapter assembly is provided and generally referred to as 400. Adapterassembly 400 is substantially similar to adapter assembly 200 and isonly described herein to the extent necessary to describe thedifferences in construction and operation thereof. Adapter assembly 400includes a proximal housing assembly 402, a distal housing assembly 404,an outer tube 406, a firing shaft assembly 407, an articulation assembly408, and a trigger assembly 410. Proximal housing assembly 402 includesa proximal housing 402 a, a release button 402 b, and a pair of screws402 c that couple to the articulation assembly 400. Distal housingassembly 404 includes a first-half section 404 a and a second-halfsection 404 b that couple to proximal housing assembly 402 and support aproximal portion of articulation assembly 408.

Trigger assembly 410 includes a trigger 412 with a magnetic area 412 a,support tube 414, a switch assembly 416, and a hall effect switch (PCB)418. Switch assembly 416 includes a pair of tactile domes 416 a, a pairof inner springs 416 b, a pair of plungers 416 c, and a pair of outersprings 416 d. The pairs of inner and outer springs 416 b, 416 dcooperate with the pair of plungers 416 c to bias trigger 410 to acentered position (see FIG. 23). As illustrated by line “D,” trigger 412is axially movably supported within distal and proximal housings 402,404 and actuatable to move magnetic area 412 a of trigger 412. The pairof tactile domes 416 a is configured to provide an audible click as thepair of plungers 416 c contact the pair of tactile domes 416 a toindicate an end of trigger travel.

In operation, movement of magnetic area 412 a of trigger 412 relative toHall Effect switch 418 creates a magnetic field and generates anelectrical signal that communicates with the circuit board of surgicalinstrument 100 to activate rotatable drive member 106 b of surgicalinstrument 100. Rotation of rotatable drive member 106 b rotates firingshaft assembly 407 to fire loading unit 300 as describe above.

Any of the components described herein may be fabricated from eithermetals, plastics, resins, composites or the like taking intoconsideration strength, durability, wearability, weight, resistance tocorrosion, ease of manufacturing, cost of manufacturing, and the like.

In embodiments, any of the components described herein, such as the endeffector and/or adapter, can include one or more microchips, such as,for example a one-wire microchip (e.g., microchip model nos. DS2465,DS28E15, and/or DS2432, available from MAXIM INTEGRATED™, San Jose,Calif.) that electrically couple to the circuit board/controller ofsurgical device 100. Exemplary one-wire microchips are shown anddescribed in U.S. Pat. No. 6,239,732, the entire content of which isincorporated herein by reference. Any of these chips can includeencrypted authentication (e.g., SULU ID) and/or may be one wirecompatible.

Persons skilled in the art will understand that the structures andmethods specifically described herein and shown in the accompanyingfigures are non-limiting exemplary embodiments, and that thedescription, disclosure, and figures should be construed merely asexemplary of particular embodiments. It is to be understood, therefore,that the present disclosure is not limited to the precise embodimentsdescribed, and that various other changes and modifications may beeffected by one skilled in the art without departing from the scope orspirit of the disclosure. Additionally, the elements and features shownor described in connection with certain embodiments may be combined withthe elements and features of certain other embodiments without departingfrom the scope of the present disclosure, and that such modificationsand variations are also included within the scope of the presentdisclosure. Accordingly, the subject matter of the present disclosure isnot limited by what has been particularly shown and described.

The invention claimed is:
 1. An adapter assembly for selectivelyinterconnecting a surgical loading unit that is configured to perform afunction and a surgical device that is configured to actuate thesurgical loading unit, the adapter assembly comprising: a housing; anouter tube supported by the housing and defining a longitudinal axis; agimbal supported in the outer tube; and a plurality of threaded sleevessupported in the housing and coupled to the gimbal by at least onecable, the plurality of threaded sleeves supported on at least onethreaded screw, at least one threaded sleeve of the plurality ofthreaded sleeves positioned to move the at least one cable relative tothe outer tube to omni-directionally articulate the gimbal and thesurgical loading unit relative to the longitudinal axis of the outertube.
 2. The adapter assembly of claim 1, further including a firingshaft configured to couple to the surgical loading unit to enable firingof the surgical loading unit.
 3. The adapter assembly of claim 2,wherein the firing shaft is configured to transmit a rotational forcethrough the gimbal.
 4. The adapter assembly of claim 3, wherein thefiring shaft includes a proximal firing shaft and a distal firing shaft,the proximal and distal firing shafts coupled together within the gimbalsuch that the distal firing shaft is movable relative to the proximalfiring shaft.
 5. The adapter assembly of claim 4, wherein the proximalfiring shaft includes a ball member and the distal firing shaft includesa socket, the socket defining a socket bore, the ball member of theproximal firing shaft mounted within the socket bore.
 6. The adapterassembly of claim 5, wherein the gimbal defines a gimbal boretherethrough, the gimbal bore configured to receive the distal firingshaft.
 7. The adapter assembly of claim 1, wherein the gimbal defines atleast one slot in an outer surface thereof, the at least one cable beingsecured within the at least one slot.
 8. The adapter assembly of claim1, wherein the outer tube includes a distal housing assembly configuredto engage the surgical loading unit, and the gimbal includes a distalflange configured to engage the distal housing assembly to enable thesurgical loading unit to articulate in response to movement of thegimbal.
 9. The adapter assembly of claim 1, wherein the at least onethreaded screw includes a first set of threads and a second set ofthreads, the first and second set of threads threaded in oppositedirections, wherein a first one of the plurality of threaded sleeves isthreadably engaged with the first set of threads and a second one of theplurality of threaded sleeves is threadably engaged with the second setof threads.
 10. The adapter assembly of claim 1, further including afiring trigger secured to the housing.
 11. An electromechanical surgicalsystem, comprising: a surgical loading unit; an electromechanicalsurgical device; and an adapter assembly selectively connectable betweenthe electromechanical surgical device and the surgical loading unit, theadapter assembly including: a gimbal and a plurality of threadedsleeves, the plurality of threaded sleeves coupled to the gimbal by atleast one cable, the plurality of threaded sleeves supported on at leastone threaded screw, the plurality of threaded sleeves being movable toarticulate the gimbal with the at least one cable, wherein articulationof the gimbal articulates the surgical loading unit; and a firing shaftmovable with the gimbal to omni-directionally articulate the surgicalloading unit and rotatable to fire the surgical loading unit.
 12. Theelectromechanical surgical system of claim 11, wherein the firing shaftincludes a proximal firing shaft and a distal firing shaft, the proximaland distal firing shafts coupled together within the gimbal such thatthe distal firing shaft is movable relative to the proximal firingshaft.
 13. The electromechanical surgical system of claim 12, whereinthe proximal firing shaft includes a ball member and the distal firingshaft includes a socket, the socket defining a socket bore, the ballmember of the proximal firing shaft being mounted within the socketbore.
 14. The electromechanical surgical system of claim 13, wherein thegimbal defines a gimbal bore therethrough, the gimbal bore configured toreceive the distal firing shaft.
 15. The electromechanical surgicalsystem of claim 11, wherein the gimbal defines at least one slot in anouter surface thereof, the at least one cable being secured within theat least one slot.
 16. The electromechanical surgical system of claim11, wherein the gimbal includes a distal flange configured to enable thesurgical loading unit to articulate in response to movement of thegimbal.
 17. The electromechanical surgical system of claim 11, whereinthe at least one threaded screw includes a first set of threads and asecond set of threads, the first and second set of threads beingthreaded in opposite directions, wherein a first one of the plurality ofthreaded sleeves is threadably engaged with the first set of threads anda second one of the plurality of threaded sleeves is threadably engagedwith the second set of threads.
 18. The electromechanical surgicalsystem of claim 11, wherein a firing trigger is secured to the adapterassembly.